Measuring consumer experiences with primary care

Objective. To assess the adequacy of the Primary Care Assessment Tool-Child Edition (PCAT-CE) for evaluating the attainment of the key characteristics of primary care services for children and youth. Design. Community-based telephone survey. Setting. Specific political subdivision in Washington, DC. Participants. Four hundred fifty parents/guardians of offspring 18 years of age or less. Measures. Reliability, validity and principal component analysis of 5 scale s representing key aspects of the 4 cardinal domains of primary care includ ed in the PCAT-CE. In addition, 2 subdomains (first contact use and extent of affiliation with a primary care source) were included as indices to desc ribe overall patterns of use and affiliation with the particular source of care. Results. Most scales had adequate internal consistency, test-retest reliabi lity, and construct validity. The principal components factor analysis yiel ded 5 separate factors. These corresponded to the subdomains of first conta ct accessibility; coordination of care; characteristics of the professional -patient relationship over-time; and comprehensiveness (both services avail able and indicated services received). Conclusions. Psychometric assessment supported the integrity and general ad equacy of the PCAT-CE for assessing the characteristics and quality of prim ary care for children and youth. Testing of revised versions in a variety o f different settings is underway. A major component of this testing is to e xplore the possibility of reducing the number of items while retaining suff icient detail about each component of primary care to make judgements about people's experiences with that care.